Caring for Patients with Delirium in the Intensive Care Unit

Patients in hospital intensive care units are at increased risk to develop delirium, a condition which is characterized by a disturbance of consciousness and a change in cognition. Critical care nurses must have the knowledge to assess, recognize, and manage delirium. The purpose of this project was to develop an evidence-based policy for the assessment of delirium and a comprehensive nursing education plan which included an analysis and synthesis of the literature, a curriculum plan, and a pretest/posttest. The Johns Hopkins Evidence-Based Practice Model framed the project, which used a multidisciplinary team approach. Two nursing leaders, each with a doctor of philosophy degree, served as content experts for the educational curriculum plan and the pretest/posttest. The curriculum plan was evaluated using a dichotomous scale of 1 = not met and 2 = met. An average score of 2 was achieved showing the content met the objectives. The pretest/posttest items were validated using a Likert-type scale ranging from 1 = not relevant to 4 = very relevant. A content validation index score of 1.0 was computed, revealing that the items met the objectives and content of the curriculum. The pretest/posttest was administered before and after the educational program to determine the knowledge gained. A paired samples t test was conducted and found to have a statistically significant difference in the scores for the pretest (M = 81.25, SD = 11.29) and post-test (M = 94.06, SD = 7.12); t (31) = -5.92, p = 0.01, revealing that the critical care nurses gained significant knowledge with the delirium educational program. This project can promote positive social change because early recognition and management of the patient with delirium can facilitate positive outcomes for patients, families, and systems